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A novel pneumatic drill for bone biopsy under MRI imaging

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

Bone biopsies are currently conducted under computed tomography (CT) guidance using a battery-powered drill to obtain tissue samples for diagnosis of suspicious bone lesions. However, this procedure is suboptimal as images produced under CT lack soft tissue discrimination and involve ionizing radiation. Therefore, our team developed an MRI-safe pneumatic drill to translate this clinical workflow into the MR environment, which can improve target visualization and eliminate radiation exposure. We compare drill times and quality of samples between the 2 drills using animal bones.

Methods

Five porcine spare rib bones were obtained from a butcher shop. Each bone was drilled twice using the Arrow OnControl battery-powered drill and twice using our pneumatically actuated drill. For this study, we used an 11-gauge bone biopsy needle set with an internal core capturing thread. A stopwatch recorded the overall time of drilling for each specimen obtained.

Results

All 20 samples collected contained a high-quality inner core and cortex. The total average time for drilling with the pneumatic drill was 8.5 s (+ / − 2.5 s) and 7.1 s (+ / − 1.4 s) with the standard battery-powered drill.

Conclusion

Both drills worked well and were able to obtain comparable specimens. The pneumatic drill took slightly longer, 1.39 s on average, but this extra time would not be significant in clinical practice. We plan to use the pneumatic drill to enable MRI-safe bone biopsy for musculoskeletal lesions. Biopsy under MRI would provide excellent lesion visualization with no ionizing radiation.

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Acknowledgements

This study is supported by the project “Pneumatic Drill and Robot for MRI-Guided Pediatrics Long Bone Biopsy” funded by NIH (Project No. 1R01CA248191-01). Responsibility for the content of this publication lies with the authors. A poster and short communication regarding an adjacent study that featured this drill was published in the SPIE 2023 Conference Proceedings.

Funding

National Cancer Institute (5R01CA248191-03).

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Author notes

  1. Elizabeth Fischer and Mikias Gebremeskel have contributed jointly to this work and should be considered co-first authors.

Authors and Affiliations

  1. Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s National Hospital, Washington, DC, USA

    Elizabeth Fischer, Mikias Gebremeskel, Karun Sharma & Kevin Cleary

  2. Brady Urological Institute, Johns Hopkins Medicine, Baltimore, MD, USA

    Dan Stoianovici

Authors
  1. Elizabeth Fischer
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  2. Mikias Gebremeskel
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  3. Dan Stoianovici
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  4. Karun Sharma
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  5. Kevin Cleary
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Correspondence to Elizabeth Fischer.

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Fischer, E., Gebremeskel, M., Stoianovici, D. et al. A novel pneumatic drill for bone biopsy under MRI imaging. Int J CARS 19, 405–409 (2024). https://doi.org/10.1007/s11548-023-03042-6

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